title: Safe right bundle branch block pattern during permanent right ventricular pacing: a case report.
abstract: We present the case of a 72-year-old male who underwent a permanent transvenous DDD pacemaker implantation for symptomatic complete heart block. The postoperative surface electrocardiogram (ECG) revealed a right bundle branch block (RBBB) pacing pattern with transition in lead V3 and left bundle branch block (LBBB) in D1, suggesting a malpositioned ventricular lead in the left heart. Malposition of a lead was ruled out by chest X-ray and echocardiogram confirming apical right ventricular pacing. After a literature review, a surface ECG maneuver, by placing leads V1 and V2 one intercostal space lower, restored the usual patterns of paced LBBB pattern. We discuss the literature concerning safe-paced RBBB.
authors.affiliation: Department of Cardiology, Avicenne Hospital, (Assistance Publique Des Hôpitaux De Paris), Bobigny, France. a.errahmouni@gmail.com.
authors.forename: Abdelkarim
authors.initials: A
authors.lastname: Errahmouni
authors.forename: Jean Christophe
authors.initials: JC
authors.lastname: Charniot
authors.forename: Jean Yves
authors.initials: JY
authors.lastname: Artigou
mesh_terms: D000368:Aged; D002037:Bundle-Branch Block / Q000175:diagnosis / Q000503:physiopathology*; D002304:Cardiac Pacing, Artificial; D004562:Electrocardiography; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial